Kevin E Duong, Sonya S Henry, Michael D Cabana, Tim Q Duong
{"title":"SARS-CoV-2感染对哮喘加重的长期影响","authors":"Kevin E Duong, Sonya S Henry, Michael D Cabana, Tim Q Duong","doi":"10.1016/j.jaip.2025.05.010","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The long-term impact of COVID-19 on asthma exacerbations remains unclear.</p><p><strong>Objective: </strong>We assessed the future risk of asthma exacerbations after SARS-CoV-2 infection in pediatric and adult asthma patients.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 12,719 asthma patients with SARS-CoV-2 infection (polymerase-chain-reaction test confirmed) and 91,763 without recorded SARS-CoV-2 infection in a large urban health care system (03/1/2020-12/31/2023). After matching on observation time, age, race, and ethnicity, 1898 children and 8532 adults were included in each group (with and without COVID-19). Andersen-Gill models adjusted for covariates (e.g., allergic rhinitis, GERD, eczema, obesity, unmet social needs) were used to calculate adjusted hazard ratios (aHR) for recurrent asthma exacerbations.</p><p><strong>Results: </strong>Both hospitalized and non-hospitalized COVID-19 children with pre-existing asthma had higher exacerbation rates than controls (40.68%, 24.81%, vs. 14.70%, p<0.001) and increased risk of future exacerbations (aHR=3.29 [2.27, 4.76]; aHR=1.82 [1.51, 2.21]), p<0.001). Adults also showed increased asthma exacerbation rates in hospitalized (23.13%) and non-hospitalized (21.49%) individuals when compared with controls (10.68%), p<0.001. Similarly, both hospitalized and non-hospitalized COVID-19 adults had increased risk of future exacerbations (aHR=2.78 [2.29, 3.38]; aHR=2.13 [1.73, 2.62]). Overall, children faced higher risks than adults. Unmet social needs elevated risk of future exacerbation in children (aHR=1.36 [1.00, 1.86]) and adults (aHR=1.26 [1.04, 1.52]).</p><p><strong>Conclusions: </strong>SARS-CoV-2 infection was associated with a higher cumulative incidence of asthma exacerbations. Patients with unmet social needs were at higher risk of exacerbation. Clinicians should prioritize preventive strategies, trigger reduction, and immunizations for patients with a history of asthma and SARS-CoV-2 infection.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2000,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Longer Term Effects of SARS-CoV-2 infection on Asthma Exacerbation.\",\"authors\":\"Kevin E Duong, Sonya S Henry, Michael D Cabana, Tim Q Duong\",\"doi\":\"10.1016/j.jaip.2025.05.010\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The long-term impact of COVID-19 on asthma exacerbations remains unclear.</p><p><strong>Objective: </strong>We assessed the future risk of asthma exacerbations after SARS-CoV-2 infection in pediatric and adult asthma patients.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 12,719 asthma patients with SARS-CoV-2 infection (polymerase-chain-reaction test confirmed) and 91,763 without recorded SARS-CoV-2 infection in a large urban health care system (03/1/2020-12/31/2023). After matching on observation time, age, race, and ethnicity, 1898 children and 8532 adults were included in each group (with and without COVID-19). Andersen-Gill models adjusted for covariates (e.g., allergic rhinitis, GERD, eczema, obesity, unmet social needs) were used to calculate adjusted hazard ratios (aHR) for recurrent asthma exacerbations.</p><p><strong>Results: </strong>Both hospitalized and non-hospitalized COVID-19 children with pre-existing asthma had higher exacerbation rates than controls (40.68%, 24.81%, vs. 14.70%, p<0.001) and increased risk of future exacerbations (aHR=3.29 [2.27, 4.76]; aHR=1.82 [1.51, 2.21]), p<0.001). Adults also showed increased asthma exacerbation rates in hospitalized (23.13%) and non-hospitalized (21.49%) individuals when compared with controls (10.68%), p<0.001. Similarly, both hospitalized and non-hospitalized COVID-19 adults had increased risk of future exacerbations (aHR=2.78 [2.29, 3.38]; aHR=2.13 [1.73, 2.62]). Overall, children faced higher risks than adults. Unmet social needs elevated risk of future exacerbation in children (aHR=1.36 [1.00, 1.86]) and adults (aHR=1.26 [1.04, 1.52]).</p><p><strong>Conclusions: </strong>SARS-CoV-2 infection was associated with a higher cumulative incidence of asthma exacerbations. Patients with unmet social needs were at higher risk of exacerbation. Clinicians should prioritize preventive strategies, trigger reduction, and immunizations for patients with a history of asthma and SARS-CoV-2 infection.</p>\",\"PeriodicalId\":51323,\"journal\":{\"name\":\"Journal of Allergy and Clinical Immunology-In Practice\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":8.2000,\"publicationDate\":\"2025-05-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Allergy and Clinical Immunology-In Practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jaip.2025.05.010\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ALLERGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Allergy and Clinical Immunology-In Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jaip.2025.05.010","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ALLERGY","Score":null,"Total":0}
Longer Term Effects of SARS-CoV-2 infection on Asthma Exacerbation.
Background: The long-term impact of COVID-19 on asthma exacerbations remains unclear.
Objective: We assessed the future risk of asthma exacerbations after SARS-CoV-2 infection in pediatric and adult asthma patients.
Methods: We conducted a retrospective cohort study of 12,719 asthma patients with SARS-CoV-2 infection (polymerase-chain-reaction test confirmed) and 91,763 without recorded SARS-CoV-2 infection in a large urban health care system (03/1/2020-12/31/2023). After matching on observation time, age, race, and ethnicity, 1898 children and 8532 adults were included in each group (with and without COVID-19). Andersen-Gill models adjusted for covariates (e.g., allergic rhinitis, GERD, eczema, obesity, unmet social needs) were used to calculate adjusted hazard ratios (aHR) for recurrent asthma exacerbations.
Results: Both hospitalized and non-hospitalized COVID-19 children with pre-existing asthma had higher exacerbation rates than controls (40.68%, 24.81%, vs. 14.70%, p<0.001) and increased risk of future exacerbations (aHR=3.29 [2.27, 4.76]; aHR=1.82 [1.51, 2.21]), p<0.001). Adults also showed increased asthma exacerbation rates in hospitalized (23.13%) and non-hospitalized (21.49%) individuals when compared with controls (10.68%), p<0.001. Similarly, both hospitalized and non-hospitalized COVID-19 adults had increased risk of future exacerbations (aHR=2.78 [2.29, 3.38]; aHR=2.13 [1.73, 2.62]). Overall, children faced higher risks than adults. Unmet social needs elevated risk of future exacerbation in children (aHR=1.36 [1.00, 1.86]) and adults (aHR=1.26 [1.04, 1.52]).
Conclusions: SARS-CoV-2 infection was associated with a higher cumulative incidence of asthma exacerbations. Patients with unmet social needs were at higher risk of exacerbation. Clinicians should prioritize preventive strategies, trigger reduction, and immunizations for patients with a history of asthma and SARS-CoV-2 infection.
期刊介绍：
JACI: In Practice is an official publication of the American Academy of Allergy, Asthma & Immunology (AAAAI). It is a companion title to The Journal of Allergy and Clinical Immunology, and it aims to provide timely clinical papers, case reports, and management recommendations to clinical allergists and other physicians dealing with allergic and immunologic diseases in their practice. The mission of JACI: In Practice is to offer valid and impactful information that supports evidence-based clinical decisions in the diagnosis and management of asthma, allergies, immunologic conditions, and related diseases.
This journal publishes articles on various conditions treated by allergist-immunologists, including food allergy, respiratory disorders (such as asthma, rhinitis, nasal polyps, sinusitis, cough, ABPA, and hypersensitivity pneumonitis), drug allergy, insect sting allergy, anaphylaxis, dermatologic disorders (such as atopic dermatitis, contact dermatitis, urticaria, angioedema, and HAE), immunodeficiency, autoinflammatory syndromes, eosinophilic disorders, and mast cell disorders.
The focus of the journal is on providing cutting-edge clinical information that practitioners can use in their everyday practice or to acquire new knowledge and skills for the benefit of their patients. However, mechanistic or translational studies without immediate or near future clinical relevance, as well as animal studies, are not within the scope of the journal.
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